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NPI Code Detail

MEDICARE: MR. SANDEE JEAN BAKER MFT

MEDICARE:  MR. SANDEE JEAN BAKER  MFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMFC40395CA

General Provider Information

NPI Number : 1619990223
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SANDEE JEAN BAKER MFT
Provider Business Mailing Address
First Line : 1012 N MOUNTAIN VIEW PL
Second Line :
City : FULLERTON
State : CA
Zip : 92831-3010
Country : US
Telephone Number : 714-425-5741
Fax Number :
Provider Business Practice Location Address
First Line : 17542 IRVINE BLVD STE F
Second Line :
City : TUSTIN
State : CA
Zip : 92780-3155
Country : US
Telephone Number : 714-508-1919
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 07/08/2007

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Directions to “ MR. SANDEE JEAN BAKER MFT” Practice Location

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